Perfil lipídico e aspectos nutricionais de crianças e adolescentes com malária por Plasmodium vivax, no município de Anajás-PA

Abstract

Objective: To evaluate the social-demographic and epidemiologic aspects of children and adolescents residents in the municipality of Anajás-PA, with P. vivax Malaria and to associate the lipid profile to the nutritional status, parasitemia and number of episodes of the disease. Methods: An observational, analytical-prospective study with children and adolescents aged 2-16, between January, 2014 and September, 2016. It was selected two groups of study: a) Cases (n=58): children and adolescents with a positive diagnosis to P. vivax and; b) Control (n=61): healthy children and adolescents without any history of Malaria and with two negative exam for Malaria. Social-demographic and anthropometric (weight, height) data were collected and it was carried out a clinical examination. The lipid profile (cholesterol and fractions, triglycerides) was determined in venous blood collected after 12 hours of fast. In the participants of the Case group, collection has occurred in three moments: D0 (day of diagnosis and admission to the study), D7 and D14 (post -treatment). Results: Most participants of the Case group was male (65,5%), whose mothers or legal tutors presented a maximum of four years of formal education, lived with minimum wage and had the government benefit program of “Bolsa Família”. The evaluation of the nutritional status pointed out a high percentage of linear growth deficits for children (25,0%), as well as for the adolescents (22,2%) in the Case group, when compared to the Control group (p<0.05). The BMI has indicated and adequacy of weight and height, independently from the group of study. It was not observed significant associations between the nutritional status (independently from the index used) with the history of Malaria, levels of parasitemia and clinical manifestations. The evaluation of the lipid profile has indicated that the Case group has presented the levels of total cholesterol and LDL-c in its wished limits and low level of HDL-C (p<0.05), when compared to the Control group. All participants presented hyper-triglyceridemia, independently from the group studied. Sex, age, parasitemia at admission and history of Malaria did not significantly influence the levels of serum lipids. It was observed significant alterations in the lipid levels in the cases follow up, characterized by the significant reduction (p<0.05) of the levels of triglycerides and VLDL between D0 and D14 and significant raise (p<0.05) of the total cholesterol, HDL and LDL-c. The serum levels of total cholesterol and LDL-c were similar at admission and D7. However, the levels of triglycerides and VLDL have quickly decreased so that they were similar between D7 and D14. Conclusion: Malaria has predominated in male children and adolescents with unfavorable socioeconomic conditions. The cases presented a high percentage of linear growth deficits, though it was with a low significance when compared to the Control group. There is a modification of the lipid profile in the acute phase of the disease.